Purpose <p>The ONCORAL multidisciplinary city-hospital follow-up aims to prevent and manage Drug-related problems (DRPs). This study describes and assesses the impact of ONCORAL on relative dose intensity (RDI) at 6&#xa0;months of the oral anticancer drug (OAD) in older patients.</p> Methods <p>Clinical information, medication, Complementary and Alternative Medicine (CAM) use and ONCORAL consultations reports were collected up to six months after initiation of OAD. For patients still treated at 6&#xa0;months, RDI (ratio between the prescribed dose and the recommended dose according to Summary of Product characteristics) was calculated for each OAD. Outpatients aged ≥75&#xa0;years followed in ONCORAL between February, 2016 and May, 2022 were included in this study. For patients treated with several subsequent OAD, all associated courses of ONCORAL follow-up were included.</p> Results <p>On hundred ninety patients were included (232 follow-ups) with a mean age of 81 ± 4.7&#xa0;years. Most patients were treated for hematologic malignancies (77.9%) and had a Charlson index &gt; 5 (56.3%). Polypharmacy (≥5 daily drugs) concerned 83.7% of patients. Mean RDI was 81.9% for 146 patients who reached 6&#xa0;months of OAD treatment (165 follow-ups), with a RDI ≥ 85% in 60% of cases. OAD premature discontinuations were due to adverse events (35.8%) or disease progression (35.8%). 1331 DRPs prompted the intervention of the ONCORAL team.</p> Conclusions <p>Despite some dose reductions, RDI at 6&#xa0;months remained satisfying for most patients, suggesting that ONCORAL improves patient care. These first results promote the development of multidisciplinary follow-up for older patients treated with OAD who are prone to DRPs.</p>

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Impact of the ONCORAL multidisciplinary city-hospital follow-up on older patients with cancer treated with oral anticancer drugs

  • Fatine Tamouro,
  • Chloé Herledan,
  • Anissa Guillemin,
  • Marie-Anne Cerfon,
  • Anne-Gaëlle Ruiz-Caffin,
  • Gabriel Antherieu,
  • Claire Falandry,
  • Lionel Karlin,
  • Hervé Ghesquieres,
  • Florence Ranchon,
  • Catherine Rioufol

摘要

Purpose

The ONCORAL multidisciplinary city-hospital follow-up aims to prevent and manage Drug-related problems (DRPs). This study describes and assesses the impact of ONCORAL on relative dose intensity (RDI) at 6 months of the oral anticancer drug (OAD) in older patients.

Methods

Clinical information, medication, Complementary and Alternative Medicine (CAM) use and ONCORAL consultations reports were collected up to six months after initiation of OAD. For patients still treated at 6 months, RDI (ratio between the prescribed dose and the recommended dose according to Summary of Product characteristics) was calculated for each OAD. Outpatients aged ≥75 years followed in ONCORAL between February, 2016 and May, 2022 were included in this study. For patients treated with several subsequent OAD, all associated courses of ONCORAL follow-up were included.

Results

On hundred ninety patients were included (232 follow-ups) with a mean age of 81 ± 4.7 years. Most patients were treated for hematologic malignancies (77.9%) and had a Charlson index > 5 (56.3%). Polypharmacy (≥5 daily drugs) concerned 83.7% of patients. Mean RDI was 81.9% for 146 patients who reached 6 months of OAD treatment (165 follow-ups), with a RDI ≥ 85% in 60% of cases. OAD premature discontinuations were due to adverse events (35.8%) or disease progression (35.8%). 1331 DRPs prompted the intervention of the ONCORAL team.

Conclusions

Despite some dose reductions, RDI at 6 months remained satisfying for most patients, suggesting that ONCORAL improves patient care. These first results promote the development of multidisciplinary follow-up for older patients treated with OAD who are prone to DRPs.